Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance

Revista da Sociedade Brasileira de Medicina Tropical

Juliana Pena Porto²  Orlando Cesar Mantese¹  Aglai Arantes¹  Claudete Freitas²  Paulo Pinto Gontijo Filho²  Rosineide Marques Ribas² 

[1] ,Universidade Federal de Uberlândia Instituto de Ciências Biomédicas Programa de Pós-graduação em Imunologia e Parasitologia AplicadasUberlândia MG

关键词: Nosocomial infections;    Pediatric ICU;    Surveillance system;    Infecções hospitalares;    UTI pediátrica;    Sistema de vigilância;   

DOI  :  10.1590/S0037-86822012005000003

来源: SciELO

【 摘 要 】

INTRODUCTION: This study aimed to determine the epidemiology of the three most common nosocomial infections (NI), namely, sepsis, pneumonia, and urinary tract infection (UTI), in a pediatric intensive care unit (PICU) in a developing country and to define the risk factors associated with NI. METHODS: We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN) was conducted in the unit and children with NI (cases) were compared with a group (matched controls) in a case-control fashion. RESULTS: We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each); Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%), and in UTI the most frequent agents were yeasts (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube), and use of antibiotics. The last two were independent factors for NI. CONCLUSIONS: The incidence of NI acquired in this unit was high and was associated with extrinsic factors.

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